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Individual

MR. REINALDO EDUARDO BUSTAMANTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RDH

Contact information

Practice address
227 MADISON ST, GOUVERNEUR HOSPITAL, NEW YORK, NY 10002
(718) 378-0521
Mailing address
1134 E 165TH ST, APT # 3B, BRONX, NY 10459-2573
(718) 378-0521

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
021018
NY

Other

Enumeration date
06/03/2006
Last updated
07/08/2007
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